Anabolic Steroid Abuse
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
- Anabolic steroid abuse facts
- What are anabolic steroids?
- Why do people abuse anabolic steroids?
- How do people abuse anabolic steroids?
- Are anabolic steroids addictive? What are the symptoms and signs of anabolic steroid abuse?
- What are the psychological and physical side effects of anabolic steroid abuse?
- How are anabolic steroid abuse and addiction diagnosed?
- What is the treatment for anabolic steroid abuse and addiction?
- Is it possible to prevent anabolic steroid abuse and addiction?
- Where can I get more information on anabolic steroid abuse?
Anabolic steroid abuse facts
- Anabolic steroids are used illegally to increase muscle, decrease fat, and enhance athletic performance and body appearance.
- Anabolic steroids act by increasing the androgenic testosterone effects within the body.
- Anabolic steroids can lead to potentially fatal side effects.
- Anabolic steroids may be addictive, and users may go through withdrawal.
- Prevention requires community education, as well as reviewing why adolescents may want to start using the drugs and understanding the risks involved.
What are anabolic steroids?
Anabolic steroids are one type of performance-enhancing drug or medication. They mimic testosterone in the body to enhance performance by making muscle cells larger and by allowing the body to recover more quickly from the stress of exercise. Slang for anabolic steroids is roids.
Performance-enhancing drugs are no longer just for bodybuilders or pro athletes who are willing to try illegal and potentially dangerous means to improve their body's function. These drugs are being used every day by people of all ages, from middle-school, high-school, and college students to older recreational athletes.
There are two types of steroids that are naturally produced in the body:
Catabolic steroids or glucocorticoids are part of the body's response to stress. The word catabolic comes from the Greek word meaning to "throw down," and these steroids help break down large chemicals into smaller ones. For example, cortisol helps glycogen (a large molecule that is stored in the liver) metabolize into glucose, a small molecule that can be used for energy by the body. Cortisol naturally is manufactured in the adrenal glands and is required for many of the basic functions of the body, including glucose metabolism, the immune response to infection, and protein, fat, and carbohydrate metabolism. Prescription medications, such as prednisone (Deltasone, Liquid Pred), hydrocortisone (Westcort), and dexamethasone (Decadron [discontinued], DexPak), are examples of steroids that are used to reduce inflammation and treat a range of illnesses from asthma and COPD to rheumatoid arthritis and allergic reactions. Low-dose hydrocortisone is the active ingredient in creams that help treat the inflammation from insect bites, poison ivy, eczema, and other local skin irritations.
Anabolic androgenic steroids are steroids that mimic testosterone in the body. Anabolic refers to the properties of these drugs to increase production of proteins that act as building blocks for muscle cells, bone, and other tissues within the body. The androgenic response (andro=male + genic=formation) describes the increased male features (secondary sexual characteristics) that occur as a result of androgenic steroids, including facial, body, and pubic hair, deepened voice, and increased sex drive or libido.
There are medical indications for prescribing these medications. Some include the following:
- Inadequate testosterone production in the body, either because of inborn errors of metabolism or because of illnesses that decrease production
- Certain types of anemia
- Recovery from major illness or injury, including burns, where the body's metabolism needs to be increased to produce more protein
- An adjunct treatment for certain types of breast cancer
- Hereditary angioedema
- HIV wasting syndrome
- Growth failure and short statures in the pediatric population
Some physicians believe that the decreased testosterone levels that occurs normally with aging is an indication for replacement therapy with anabolic steroids, but their use in otherwise healthy older patients is still controversial because of the potential serious side effects.
There are many different types of anabolic steroids that have been manufactured over the past decades. The goal of chemists is to promote the anabolic effect of the drug while decreasing the androgenic side effects that can be life-threatening. Examples of anabolic steroids include the following:
- Testosterone (Axiron, Androgel, Fortesta, Testopel, Striant, Delatestryl, Testim, Androderm)
- Stanozolol (Winstrol)
- Nandrolone (Deca-Durabolin)
- Methandrosteolone (Dianabol)
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